NPI | 1124514070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 56272) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MTL2000283) |
Enumeration Date | 2018-07-03 |
Last Update Date | 2022-05-27 |